National Voluntary Consensus Standards For Ambulatory Care Using Clinically Enriched Administrative Data
Current Activity:
The Opportunity
In recent years, NQF has endorsed more than 150 clinician-level ambulatory care measures which rely heavily on medical record reviews or physician-directed coding to assess performance. Performance measures that can be derived from ambulatory administrative data alone are very limited, and concerns have been raised about the accuracy and reliability of these data and measures. Fortunately, progress has been made towards improving these measures through the addition of laboratory and pharmacy data and other electronic clinical data, which when combined with administrative data, provide a rich source of information for the assessment of some aspects of performance.
About the Project
This project began in October 2008.
ObjectiveIn this project, NQF will consider quality measures for ambulatory care based on administrative data, enriched by laboratory and pharmacy data and other electronic clinical data, that can provide additional tools for purchasers, health plans, consumers, clinicians and other stakeholders working to create more feasible approaches to ongoing performance measurement and quality improvement.
ProcessCandidate measures will be considered for NQF endorsement as national voluntary consensus standards. Agreement will be developed through NQF’s Consensus Development Process (CDP, version 1.8). This project involves the active participation of representatives from across the spectrum of healthcare stakeholders and is guided by a steering committee.
FundingFunding for this project has been provided by Aetna Foundation, United Health Foundation, WellPoint and Cigna.
Related NQF WorkStandardizing Ambulatory Care Performance Measures
Contact InformationFor more information, contact Reva Winkler, MD, MPH at 202-783-1300 or via e-mail at RWinkler@qualityforum.org
NQF seeks to identify and endorse ambulatory care measures suitable for both public accountability and quality improvement that can be derived primarily from clinically enriched administrative data.
The project Steering Committee, representing the full range of stakeholder perspectives, was formed following the process set forth in NQF’s Consensus Development Process.
Steering Committee Roster (updated 8/20/09)
For additional information on the Steering Committee formation process, including specific information on conflicts of interest and required time commitment, please refer to the Call for Nominations documents.
Call for Nominations (MS Word)
Nomination Form (MS Word)
Disclosure of Interest Form (MS Word)
The Steering Committee met in person and by conference call to evaluate 206 submitted measures using established NQF evaluation criteria within the context of other available measures, with an eye toward harmonization. Other measure sources included currently endorsed measures based on administrative data, measures being considered in the concurrent Medication Management project, and endorsed ambulatory measures not based on administrative data.
The purpose of this in-person meeting was to discuss the project's objectives and to form workgroups from the committee members. The workgroups performed preliminary evaluations of the measures submitted during the call for candidate standards.
Meeting Summary
The purpose of the meeting was to review seven hypertension measures, seven geriatric measures, three mental health measures, and four osteoporosis measures. The committee was also scheduled to discuss four other measures that addressed sinusitis, cataract, gynecology, and influenza.
Agenda
The purpose of the call was to examine one gynecological measure, one influenza measure, four smoking measures, eleven prenatal measures, six pediatrics measures, five hepatitis measures, and four HIV measures.
Agenda
The purpose of the call was to review 14 medication management measures, five osteoporosis measures, four hepatitis measures, and three cancer follow-up measures.
Agenda
Member voting is now closed.
A draft report and supporting materials are available on the Member Voting Overview.
On December 4 the Board of Directors ratified the CSAC’s decision to endorse 70 Clinically Enriched Administrative Claims Measures.
The public had 30 days to appeal the decisions made to endorse this voluntary consensus standard. The appeals process closed on February 2, 2010.
NQF received two appeals regarding the endorsement of Ambulatory Care Measures Using Clinically Enriched Administrative Data.
The NQF board of directors voted to maintain endorsement of the rheumatoid arthritis measures appealed by the American College of Rheumatology, and remove endorsement of the measure for COPD (COPD with Exacerbations- Adding a Long-Acting Bronchodilator) appealed by the Tara Center/Center for Consumers of Healthcare.
